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Tensilon Test

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1. Tensilon Test

Tensilon Test Tensilon Test Toggle navigation Brain Head & Neck Chest Endocrine Abdomen Musculoskeletal Skin Infectious Disease Hematology & Oncology Cohorts Diagnostics Emergency Findings Procedures Prevention & Management Pharmacy Resuscitation Trauma Emergency Procedures Ultrasound Cardiovascular Emergencies Lung Emergencies Infectious Disease Pediatrics Neurologic Emergencies Skin Exposure Miscellaneous Abuse Cancer Administration 4 Tensilon Test Tensilon Test Aka: Tensilon Test (...) , Edrophonium Test II. Indications evaluation in suspected III. Contraindications Elderly IV. Adverse Effects Increased tion Abdominal cramping Bronchospasm V. Mechanism Edrophonium (Tensilon) is a rapid onset, short acting VI. Preparation Consider telemetry monitoring 0.5 mg IV prn symptomatic VII. Technique Edrophonium (10 mg/ml) 1 ml is drawn into a 1 cc syringe (tuberculin syringe) Inject edrophonium 2 mg (0.2 cc) IV every minute up to cummulative dose of 10 mg Stop when improvement in is observed or 10

2018 FP Notebook

2. Bulbar Myasthenia Gravis Superimposed in a Medullary Infarction Diagnosed by a Fiberoptic Endoscopic Evaluation of Swallowing With Simultaneous Tensilon Application (PubMed)

Bulbar Myasthenia Gravis Superimposed in a Medullary Infarction Diagnosed by a Fiberoptic Endoscopic Evaluation of Swallowing With Simultaneous Tensilon Application In the elderly, myasthenia gravis (MG) can present with bulbar symptoms, which can be clinically difficult to diagnose from other neurological comorbid conditions. We describe a case of a 75-year-old man who had been previously diagnosed with dysphagia associated with medullary infarction but exhibited aggravation of the dysphagia (...) later on due to a superimposed development of bulbar MG. After recovering from his initial swallowing difficulties, the patient suddenly developed ptosis, drooling, and generalized weakness with aggravated dysphagia. Two follow-up brain magnetic resonance imaging (MRI) scans displayed no new brain lesions. Antibodies to acetylcholine receptor and muscle-specific kinase were negative. Subsequent electrodiagnosis with repetitive nerve stimulation tests revealed unremarkable findings. A diagnosis

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2017 Annals of rehabilitation medicine

3. Diagnosis of Tensilon-Negative Ocular Myasthenia Gravis By Daily Selfie (PubMed)

Diagnosis of Tensilon-Negative Ocular Myasthenia Gravis By Daily Selfie The initial symptoms of myasthenia gravis are usually ptosis and diplopia. The diagnosis is often confirmed by testing for anti-acetylcholine receptor antibodies or by observing the effects of intravenous edrophonium (Tensilon) injection. However, these standard tests may be negative in patients with isolated ocular findings. We present the case of an 83-year-old woman with negative serologic and Tensilon testing. She

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2016 Journal of neuro-ophthalmology : the official journal of the North American Neuro-Ophthalmology Society

4. Tensilon Test

Tensilon Test Tensilon Test Toggle navigation Brain Head & Neck Chest Endocrine Abdomen Musculoskeletal Skin Infectious Disease Hematology & Oncology Cohorts Diagnostics Emergency Findings Procedures Prevention & Management Pharmacy Resuscitation Trauma Emergency Procedures Ultrasound Cardiovascular Emergencies Lung Emergencies Infectious Disease Pediatrics Neurologic Emergencies Skin Exposure Miscellaneous Abuse Cancer Administration 4 Tensilon Test Tensilon Test Aka: Tensilon Test (...) , Edrophonium Test II. Indications evaluation in suspected III. Contraindications Elderly IV. Adverse Effects Increased tion Abdominal cramping Bronchospasm V. Mechanism Edrophonium (Tensilon) is a rapid onset, short acting VI. Preparation Consider telemetry monitoring 0.5 mg IV prn symptomatic VII. Technique Edrophonium (10 mg/ml) 1 ml is drawn into a 1 cc syringe (tuberculin syringe) Inject edrophonium 2 mg (0.2 cc) IV every minute up to cummulative dose of 10 mg Stop when improvement in is observed or 10

2015 FP Notebook

5. Ocular myasthenia: evaluation of Tensilon tonography and electronystagmography as diagnostic tests (PubMed)

Ocular myasthenia: evaluation of Tensilon tonography and electronystagmography as diagnostic tests The value of electronystagmography (ENG) and of tonography in monitoring the beneficial effect of edrophonium chloride (Tensilon) on the extraocular muscles in myasthenia gravis has been assessed. Studies were performed on 17 patients with myasthenia gravis and on 18 control subjects, of whom nine had extraocular muscle weakness due to myopathic or neurogenic lesions.Electronystagmography recorded (...) the repetitive following movements of the eyes elicited during optokinetic nystagmus. Neuromuscular fatigue with the subsequent beneficial response to Tensilon was clearly seen in 50% of patients with myasthenia. False positive responses were not seen in control subjects but in many of these, as in the remaining myasthenic patients, the amplitude and rate of nystagmus seen in the ENG was very variable. These difficulties suggest that the ENG is of limited value as a diagnostic test in myasthenia

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1970 Journal of neurology, neurosurgery, and psychiatry

6. CRACKCast E175 – Neurologic Disorders

and supportive care. The diagnosis of infant botulism is largely clinical. If there is high clinical suspicion, treatment should be initiated promptly, without awaiting laboratory confirmation. Given the risk of respiratory compromise, infants with botulism should be admitted to the hospital for observation and supportive care. Diagnosis of myasthenia gravis in the ED may be confirmed with the Tensilon test. (remember: injection of an acetylcholine esterase inhibitor to assess for increased strength (...) gravis is usually seen in adults; however, there are three types that affect children—neonatal (transient), congenital, and juvenile. REMEMBER: MG has a waxing and waning weakness, worsens as the day goes on and often presents with bilateral ptosis. The Tensilon test may be used in the ED to confirm the diagnosis. Edrophonium (Tensilon), an acetylcholinesterase inhibitor, is administered IV. By blocking the action of acetylcholinesterase at the neuromuscular junction, the presence of acetylcholine

2018 CandiEM

7. CRACKCast E108 – Neuromuscular Disorders

with possible airway compromise. In such patients, FVC of less than 15 mL/kg or maximal NIF of less than 15 mm H2O is a potential indication for mechanical ventilation. Patients with a neuromuscular decline in respiratory function can be given a trial of noninvasive ventilation. The edrophonium (tensilon) and ice bag tests can be useful bedside tests in the evaluation of a suspected new diagnosis of myasthenia gravis. Plasma exchange therapy and IVIG are both useful for the treatment of myasthenic crises (...) triphosphatase (Na+/K+-ATPase) pump = a rapid shift of potassium from extracellular to intracellular compartment. Treatment: treat underlying electrolyte abnormality and thyroid dysfunction Wisecracks: [1] Clinically, how would you differentiate between a myasthenic crisis and a cholinergic crisis? First off, cholinergic crisis (due to excess pyridostigmine) is so bloody rare it should barely be on your radar, always treat as MG crisis first. However, with your tensilon test (aka, edrophonium, which

2017 CandiEM

8. Management of Toxicities from Immunotherapy: ESMO Clinical Practice Guidelines

Guidelines Annals of Oncology iv134 | Haanen et al. Volume 28 | Supplement 4 | August 2017Check for ocular muscle and proximal muscle fatigability AChR and anti-MuSK antibodies Bedside tests, e.g. Tensilon test or ice pack test with neurological input Repetitive nerve stimulation and single ?bre EMG Guillain (...) diseases, baseline laboratory tests and radiological exams (Supplementary Table S1, available at Annals ofOncology online) [mostly computed tomography (CT) scans of the chest, abdomen/pelvis and often brain magnetic resonance imaging (MRI)]. Patients with a history of autoimmune disease, or who are being actively treated for an autoimmune disease, are at risk for worsening of their autoimmune disease while on im- mune checkpoint blockade [16]. Similarly, patients that have had irAEs on ipilimumab

2017 European Society for Medical Oncology

9. OVEMP in Myasthenia

will be excluded from the Tensilon test as part of the reference standard. Women who are pregnant or breast feeding. Contacts and Locations Go to Information from the National Library of Medicine To learn more about this study, you or your doctor may contact the study research staff using the contact information provided by the sponsor. Please refer to this study by its ClinicalTrials.gov identifier (NCT number): NCT03049956 Contacts Layout table for location contacts Contact: Konrad P Weber, PD, MD Locations (...) Summary: Myasthenia gravis is an autoimmune disorder of neuromuscular transmission, characterized by fluctuating muscle weakness and fatigability. In isolated ocular myasthenia, when only the extraocular muscles are involved, most common ancillary tests, such as acetylcholine receptor autoantibodies and repetitive nerve stimulation, are often negative. A simple, quick and non-invasive test for ocular myasthenia based on ocular vestibular evoked myogenic potentials (oVEMP) was recently developed

2017 Clinical Trials

10. Foodborne Botulism, I Only Had Nacho Cheese: A Case Report (PubMed)

, or raw fish. The patient also denied traveling to any exotic place or recent camping trips. The edrophonium tensilon test and lumbar puncture came out to be negative. The botulinum toxin test was positive, the patient was started on botulinum antitoxin, and the rest of symptomatic treatment was continued. The Centre for Disease Control (CDC) tracked the events related to the presentation and found she had eaten nacho cheese from a gas station the day before the appearance of the symptoms. A total

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2017 Cureus

11. Seronegative Myasthenia Gravis, as a Rare Autoimmune Condition in Turner Syndrome (PubMed)

with seronegative MG but with mosaic isochromosome TS. This is a child with developmental delay presented with muscle weakness, frequent fall, and bilateral ptosis. Diagnosis of MG was made based on positive Tensilon and electromyography tests and excellent response to intravenous immunoglobulin. At the age of 11 years due to short stature and developmental delay, a karyotype was done and revealed the mosaic isochromosome 45,X/46,X,i(X)(q10). Overall, clinicians should be aware of the vulnerability of girls

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2017 Case reports in pediatrics

12. Isolated dysphagia as initial sign of anti-IgLON5 syndrome (PubMed)

Isolated dysphagia as initial sign of anti-IgLON5 syndrome To report on dysphagia as initial sign in a case of anti-IgLON5 syndrome and provide an overview of the current literature.The diagnostic workup included cerebral MRI, fiber optic endoscopic evaluation of swallowing (FEES) with the FEES tensilon test, a videofluoroscopic swallowing study, evoked potentials and peripheral nerve conduction studies, polysomnography, lumbar puncture, and screening for neural autoantibodies. A systematic

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2016 Neurology® neuroimmunology & neuroinflammation

13. A Pilot Trial To Assess The Feasibility And Efficacy Of SCIG In Patients With MG Exacerbation (SCIG-MG)

the clinical evaluation by a neuromuscular expert and meeting any two of the following supportive criteria: Abnormal Tensilon test Abnormal repetitive nerve stimulation studies Abnormal single fiber electromyography (EMG) Increased serum acetylcholine receptor or anti-MuSK antibodies Prior response to immunotherapy Exclusion Criteria: Respiratory distress requiring ICU admission or a vital capacity <1 L Severe swallowing difficulties with a high risk of aspiration Change in corticosteroid dosage in the 4 (...) , a qualitative questionnaire. [ Time Frame: Baseline - Day 42 ] Change in Manual Muscle Testing (MMT) score from baseline to day 42 after treatment. [ Time Frame: Baseline - Day 42 ] MMT is a validated clinical measure of myasthenia gravis ranging from 0 points (no myasthenic weakness) to a maximum of 128 points, with a defined change of 25% from baseline required for clinical significance. Adverse events related to SCIG infusions will be recorded if/when they occur. [ Time Frame: Baseline - Day 42 ] Patient

2015 Clinical Trials

14. Neuro-ophthalmic History (Overview)

of systemic dysthyroidism may be overlooked unless patients are carefully examined for lid retraction. Atrial fibrillation increases the risk of embolic disease. Edrophonium (Tensilon) is not available in all countries, but careful cardiopulmonary inquiry should be performed before considering edrophonium testing. [ ] Some preclude the use of MRI. In all patients with ocular myasthenia, inquire about the following symptoms that may have systemic generalization: dyspnea, dysphagia, and difficulty getting (...) such as acetazolamide (Diamox) in patients with idiopathic intracranial hypertension (pseudotumor cerebri). [ , ] In addition, contrary to popular belief, shellfish “allergy” is not a contraindication to iodinated contrast CT scan. Medical history For patients who cannot remember their medical history, the following items may help jog their memory: past surgery, hospital admissions, previous medications, reasons for seeing a physician, results of past neuroimaging studies or blood tests, and trauma (eg, motor

2014 eMedicine.com

15. Assessment of Neuromuscular Transmission (Follow-up)

reported these findings in Lancet in 1934. The Tensilon test, discussed later, is the modern version of Dr. Walker's technique. Her work, particularly when combined with the basic pharmacologic studies of contemporaries such as Dale and Feldberg on cholinergic neuromuscular transmission, suggested impairment of cholinergic transmission at the nerve-muscle synapse. [ ] Approximately 30 years prior to Dr. Walker's findings, more insight into to pathophysiology of MG had emerged. In 1901, the famous (...) to have good sensitivity and specificity, though it is probably more subject to false-positive and false-negative results than the Tensilon test. This test is often useful in those cases where one would like to do an (Tensilon) test, but the patient is either quite old or medically unstable or Tensilon is not readily available. Holding an ice pack over the eye for 1-2 minutes is unlikely to cause harm. [ , , ] Tensilon test Edrophonium chloride (Enlon, Reversol, Tensilon) is primarily used

2014 eMedicine.com

16. Assessment of Neuromuscular Transmission (Overview)

reported these findings in Lancet in 1934. The Tensilon test, discussed later, is the modern version of Dr. Walker's technique. Her work, particularly when combined with the basic pharmacologic studies of contemporaries such as Dale and Feldberg on cholinergic neuromuscular transmission, suggested impairment of cholinergic transmission at the nerve-muscle synapse. [ ] Approximately 30 years prior to Dr. Walker's findings, more insight into to pathophysiology of MG had emerged. In 1901, the famous (...) to have good sensitivity and specificity, though it is probably more subject to false-positive and false-negative results than the Tensilon test. This test is often useful in those cases where one would like to do an (Tensilon) test, but the patient is either quite old or medically unstable or Tensilon is not readily available. Holding an ice pack over the eye for 1-2 minutes is unlikely to cause harm. [ , , ] Tensilon test Edrophonium chloride (Enlon, Reversol, Tensilon) is primarily used

2014 eMedicine.com

17. Myasthenia Gravis and Pregnancy (Diagnosis)

the most sensitive data to support the diagnosis. Findings are abnormal in more than 90% of patients. This test shows abnormalities in neuromuscular transmission as increased jitter and blocking. Edrophonium Injection Intravenous injection of (Tensilon) is a routine test when symptoms and signs suggest myasthenia gravis. This cholinesterase inhibitor increases the amount of acetylcholine available, which increases the probability of acetylcholine binding to the receptor. It is the test of choice (...) Hyperthyroidism Neurasthenia Intracranial mass lesion Progressive external ophthalmoplegia Drug-induced myasthenia gravis Previous Next: Diagnostic Testing Antibody Titration Anti-AChR and anti-MuSK antibody titration is usually performed by radioimmunoassay. This is the most specific test for myasthenia gravis. Current literature suggests that anti-AChR titers do not correlate reliably with the severity of weakness in patients with myasthenia gravis. Additionally, at early stages of the disease, as well

2014 eMedicine.com

18. Myasthenia Gravis (Diagnosis)

. "Seronegative" myasthenia gravis with anti-MuSK antibodies, presenting as ocular myasthenia, is uncommon but has been described. [ ] Edrophonium testing Edrophonium (Tensilon) has become difficult to obtain in North America, so rest or sleep tests have become more commonly used. Complications such as bradycardia can occur during Tensilon tests, [ ] so atropine equipment and resuscitation equipment should be made available. Single-fiber electromyography If the diagnosis of ocular myasthenia remains (...) . Forced ductions should be normal. Orbicularis involvement Orbicularis involvement consistently is present when ocular symptoms are reported. Weakness in forceful closure of the eyes against resistance is present. With prolonged lid closure, the lids may spontaneously open (peek sign). Pupils and ciliary muscles Traditionally, pupils and ciliary muscles were believed not to be involved, although studies now suggest the contrary, notably in a case analysis by Cooper and coworkers. [ ] Sleep/rest test

2014 eMedicine.com

19. Assessment of Neuromuscular Transmission (Diagnosis)

reported these findings in Lancet in 1934. The Tensilon test, discussed later, is the modern version of Dr. Walker's technique. Her work, particularly when combined with the basic pharmacologic studies of contemporaries such as Dale and Feldberg on cholinergic neuromuscular transmission, suggested impairment of cholinergic transmission at the nerve-muscle synapse. [ ] Approximately 30 years prior to Dr. Walker's findings, more insight into to pathophysiology of MG had emerged. In 1901, the famous (...) to have good sensitivity and specificity, though it is probably more subject to false-positive and false-negative results than the Tensilon test. This test is often useful in those cases where one would like to do an (Tensilon) test, but the patient is either quite old or medically unstable or Tensilon is not readily available. Holding an ice pack over the eye for 1-2 minutes is unlikely to cause harm. [ , , ] Tensilon test Edrophonium chloride (Enlon, Reversol, Tensilon) is primarily used

2014 eMedicine.com

20. Assessment of Neuromuscular Transmission (Treatment)

reported these findings in Lancet in 1934. The Tensilon test, discussed later, is the modern version of Dr. Walker's technique. Her work, particularly when combined with the basic pharmacologic studies of contemporaries such as Dale and Feldberg on cholinergic neuromuscular transmission, suggested impairment of cholinergic transmission at the nerve-muscle synapse. [ ] Approximately 30 years prior to Dr. Walker's findings, more insight into to pathophysiology of MG had emerged. In 1901, the famous (...) to have good sensitivity and specificity, though it is probably more subject to false-positive and false-negative results than the Tensilon test. This test is often useful in those cases where one would like to do an (Tensilon) test, but the patient is either quite old or medically unstable or Tensilon is not readily available. Holding an ice pack over the eye for 1-2 minutes is unlikely to cause harm. [ , , ] Tensilon test Edrophonium chloride (Enlon, Reversol, Tensilon) is primarily used

2014 eMedicine.com

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